1653 W CHATEAU PL (5)Anaheim Union High School District
501 Crescent Way,P.O.Box 3520,Anaheim,CA 92803-3520
(714)999-5454
UNLIMITED
'2'
CERTIFICATE of COMPLIANCE
PAYMENT of SCHOOL FACILITY FEES
NOTICE:The 90-day period in which you may protest the fee described herein will begin on the date this fee is paid.However,if the fee was
imposed by the City or County as a cohdition of approval for your project,and you have received the requisite notice,the 90-day protest period
began at the time your project was approved.Returned checks (NSF)are subject to a $30.00 administrative fee.
RECEIPT NO.:ELEMENTARY DISTRICT:HIGH SCHOOL DISTRICT:
Anaheim Union High School District1A
OWNER INFORMATION:
Tffi'p/kJ)Name:
Address:M\J eH-AT£At;pL-TVMA-ffEj’iui c\A ^2S:02-
Cell{697)■Phone Number:Home (
APPLICANT INFORMATION:
Name:
Phone Number:Home (Cel[{
PROPERTY INFORMATION:
f^5 PaProjectAddress:
Development Type:{)Residential -New (}Residential -Room Addition
{)Single Family
4 ()Commercial:
()Multi-Family Condos/Apartments #of units:
\~iA\IProjectName:
COMMERCIAL:
Total Square Footage:
Multiplied by Current Rate
RESIDENTIAL:
Total Square Footage:
Multiplied by Current Rate
5 Eiem.$Elem.$_
H.S.$
=$
=$
Equals Total Fee;$=$
FEE WAIVER:
Fees Waived:{)Yes6 If yes,reason:No
ACKNOWLEDGEMENTY
e above respresentations as to square footage are true,Developer/Applicant agrees that if it is later determined that such respresentations
rjate-eity/County shall be notified.
Developer/Applicant Signatur 1
TCERTIFICATION:
This certifies that the above named Developer/Applicant has paid school facility fe^sHi
6599S.
iliance with Government Code Sections 53080 and
\8
, Representative -^ahelm Union High School District
\
Date
ACTUAL FEES PAID:ov
P g"'>v 0-Q
$Check No.
Check No.
9
$Anaheim Union H.S.Dist.
Distribution:Developer/Applicant,AUHSD Accounting Department,Elementary School District Accounting Department